Effects of Low-Dose Atorvastatin on Arterial Stiffness and Central Aortic Pressure Augmentation in Patients With Hypertension and Hypercholesterolemia.

1. Aggeliki I. Kanaki¹, Pantelis A. Sarafidis¹, Panagiotis I. Georgianos¹, Konstantinos Kanavos¹,
2. Ioannis M. Tziolas¹, Pantelis E. Zebekakis¹ andAnastasios N. Lasaridis¹

+ Author Affiliations

1. ¹Section of Nephrology and Hypertension, 1st Department of Medicine, AHEPA University Hospital, Thessaloniki, Greece.

1. Correspondence: Pantelis A. Sarafidis (psarafidis11@yahoo.gr).

• Received September 20, 2012.
• Revision received December 4, 2012.
• Accepted December 16, 2012.

Abstract

Background Experimental and clinical data suggest that statins exert anti-inflammatory and antiproliferative actions on vasculature beyond their lipid-lowering properties. Whether these pleiotropic effects of statins translate into a beneficial effect on arterial stiffness is not clear. This study aimed to evaluate the potential effects of low-dose atorvastatin treatment on arterial stiffness and central arterial pressure waveforms in patients with mild hypertension and hypercholesterolemia.

Methods In a double-blind, randomized, placebo-controlled fashion, 50 hypertensive and hypercholesterolemic patients were allocated to receive 10mg of atorvastatin or placebo for 26 weeks. Arterial stiffness was assessed by aortic pulse-wave velocity (PWV) using a Sphygmocor device. Central arterial pressure waveform parameters were estimated by radial artery applanation tonometry. Heart rate–adjusted augmentation index (AIx(75)) was used as measure of wave reflections.

Results At study end, aortic PWV (9.0±1.5 vs. 10.9±2.6 m/sec; P<0 .001="" 11.8="" 28.8="" 9.7="" aix="" and="" em="" vs="">P

< 0.001) were significantly lower in the atorvastatin group than that placebo group. Furthermore, decreases in central aortic systolic blood pressure and pulse pressure were evident at study-end with atorvastatin but not with placebo (130±8 vs. 138±6mm Hg, P < 0.001; 48±7 vs. 53±6mm Hg, P < 0.05, respectively). Atorvastatin-induced reductions in aortic PWV during follow-up showed significant associations with changes in AIx(75) and central aortic systolic blood pressure and pulse pressure.

Conclusions This study shows that low-dose atorvastatin treatment improves arterial stiffness and exerts a reduction on central aortic pressures. These effects may represent a potential mechanism of cardiovascular risk reduction observed with statin use.

Clinical Trial Registration ClinicalTrials.gov Database Identifier Number: NCT01126684